| NPI | 1255281424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY S GIBBONS Speech Language Pathologist 229-563-0364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2026-01-29 |
| Last Update Date | 2026-01-29 |